Individual provider Active NPI

Susana Mojica, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1508632878
Registry record updated Dec 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
LMT-26790 Issued in OR
Practice address
6118 SE Belmont St Ste 505
Portland, OR 97215-1983
Phone
(971) 762-9146
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LMT-26790 OR Primary

Addresses

Primary practice location

6118 SE Belmont St Ste 505
Portland, OR 97215-1983

Mailing address

6118 SE Belmont St Ste 505
Portland, OR 97215-1983
Phone (971) 762-9146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMT-26790ORMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702166400000",
    "number": "1508632878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6118 SE BELMONT ST STE 505",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151983",
            "telephone_number": "971-762-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6118 SE BELMONT ST STE 505",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151983",
            "telephone_number": "971-762-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJICA",
        "first_name": "SUSANA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-12-10",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "LMT-26790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.